Researchers studied how well folate (a B vitamin) passes from pregnant mothers to their babies when the mother has epilepsy. They found that epilepsy medications might make it harder for babies to get enough folate, even when mothers have normal folate levels in their blood. The study looked at 51 pregnant women - some with epilepsy taking medications, some with epilepsy not taking medications, and some without epilepsy. Results suggest that pregnant women with epilepsy may need closer monitoring of their folate levels and possibly higher doses of folate supplements to ensure their babies get enough of this important vitamin for healthy development.

The Quick Take

  • What they studied: How well folate (vitamin B9) transfers from pregnant mothers with epilepsy to their babies compared to mothers without epilepsy
  • Who participated: 51 pregnant women at delivery: 22 with epilepsy taking seizure medications, 10 with epilepsy not taking medications, and 19 without epilepsy
  • Key finding: Babies born to mothers with epilepsy had lower folate levels even when their mothers had adequate folate, suggesting seizure medications may interfere with folate transfer
  • What it means for you: If you have epilepsy and are pregnant or planning pregnancy, you may need extra folate monitoring and supplementation beyond standard prenatal vitamins

The Research Details

This was a cross-sectional study conducted at two medical centers. Researchers collected blood samples from both mothers and their newborn babies at the time of delivery. They measured folate levels in both the mother’s blood and the umbilical cord blood (which represents the baby’s folate levels). They also measured the levels of seizure medications in both blood samples to see how these drugs might affect folate transfer. The study compared three groups: women with epilepsy taking medications, women with epilepsy not taking medications, and women without epilepsy as a control group.

This approach allowed researchers to directly compare how much folate actually reaches the baby versus how much the mother has in her system. By studying the blood at delivery, they could see the real-time transfer of folate across the placenta, which is more accurate than trying to estimate this transfer indirectly.

The study used validated laboratory tests to measure folate levels and included appropriate control groups. However, the sample size was relatively small with only 51 participants total, which means the findings should be confirmed in larger studies before making broad recommendations.

What the Results Show

The study found that folate transfer from mother to baby appears to follow a saturable pattern in women with epilepsy, meaning there may be a limit to how much folate can cross the placenta regardless of how much folate is in the mother’s blood. This suggests that seizure medications may interfere with the placenta’s ability to transport folate efficiently. The relationship between maternal folate levels and baby’s folate levels was weaker in women with epilepsy compared to those without epilepsy. When researchers excluded premature births from their analysis, they found that the transfer pattern became more predictable, with specific maximum transfer rates that could be calculated.

The study noted that folate deficiency appeared to be common in their study group, though specific numbers weren’t provided in the abstract. Cesarean sections were more common in the control group without epilepsy, but other maternal and baby characteristics were similar across all groups.

Previous research has suggested that seizure medications can interfere with folate metabolism, but this study provides direct evidence of how this affects the actual transfer of folate to the developing baby. This fills an important gap in understanding why standard folate monitoring in pregnant women with epilepsy might not be sufficient.

The study had a small sample size of only 51 women total, which limits how broadly the findings can be applied. It was also a cross-sectional study, meaning it only looked at one point in time (delivery) rather than following women throughout pregnancy. The findings need to be confirmed in larger, longer-term studies.

The Bottom Line

Pregnant women with epilepsy should work closely with their healthcare providers to monitor folate levels throughout pregnancy, not just at the beginning. Standard prenatal folate supplementation may not be sufficient, and higher doses or more frequent monitoring may be needed. However, any changes to supplementation should be made under medical supervision.

This research is most relevant for women with epilepsy who are pregnant or planning to become pregnant, especially those taking seizure medications. Healthcare providers caring for pregnant women with epilepsy should also consider these findings when monitoring folate status.

Folate is most critical during the first trimester for preventing birth defects, but this research suggests monitoring should continue throughout pregnancy for women with epilepsy. Benefits of adequate folate supplementation can be seen within weeks to months of starting appropriate doses.

Want to Apply This Research?

  • Track daily folate supplement intake and any epilepsy medications, noting the timing of each to discuss optimal spacing with your healthcare provider
  • Set daily reminders to take prescribed folate supplements and log any missed doses to discuss patterns with your doctor
  • Request folate blood level testing at each prenatal visit if you have epilepsy, and track these results over time to ensure adequate levels are maintained throughout pregnancy

This information is for educational purposes only and should not replace medical advice. Pregnant women with epilepsy should consult with their healthcare providers before making any changes to their medication or supplement regimen. Individual medical needs may vary significantly.